NPIMap

Organization Active NPI

Citrus Health Network, Inc.

  • Community/Retail Pharmacy
  • Hialeah, FL
National Provider Identifier
1962592915
Registry record updated Sep 30, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Retail PharmacyTaxonomy code 3336C0003X
License
PH8703 Issued in FL
Legal business name
CITRUS HEALTH NETWORK, INC.
Practice address
4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone
(305) 424-3177
Fax
(305) 556-2580
NPI assigned
Oct 13, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mario Jardon
Title
Ceo
Phone
(305) 825-0300

Corporate family (same tax ID) 25

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

National Provider Directory
Tax ID family
Citrus Health Network Inc (26 organizations share this tax ID)

Networks

  • HealthSun Health Plans Network

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X
Community/Retail Pharmacy 3336C0003X PH8703 FL Primary

Addresses

NPPES NPI Registry

Primary practice location

4175 W 20TH Ave
Hialeah, FL 33012-5874

Mailing address

4175 W 20TH Ave
Hialeah, FL 33012-5874
Phone (305) 825-0300

Other identifiers 2

NPPES NPI Registry
IdentifierTypeStateIssuer
105376100MedicaidFL
2005744OtherPK

Other names 1

NPPES NPI Registry
  • Citrus Pharmacy Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 30, 2015.

{
    "created_epoch": "1160697600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1443571200000",
    "number": "1962592915",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-825-0300",
            "fax_number": "305-556-2580"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4175 W 20TH AVE",
            "city": "HIALEAH",
            "state": "FL",
            "postal_code": "330125874",
            "telephone_number": "305-424-3177",
            "fax_number": "305-556-2580"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CITRUS HEALTH NETWORK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-13",
        "last_updated": "2015-09-30",
        "status": "A",
        "authorized_official_last_name": "JARDON",
        "authorized_official_first_name": "MARIO",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "305-825-0300"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "FL",
            "license": "PH8703",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "105376100",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2005744",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Citrus Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hialeah, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.